痧者，急症也。若昏迷不醒，口不能言，其心胸烦闷，一种难过之苦，将何以辨之？治宜先观其唇舌。色黑者凶；
色黄者重；色淡红者，较之略轻。盖黄色而知内热，黑色而知热极，淡红色虽热，用药不可太冷。又要看有苔无苔，其
症始有治法矣。
痧症危急，大便不通，急宜放痧而攻之；小便不通，宜放痧而分利之。
痧症危急，若犯咽喉，则痰喘如锯，先放其痧，急用薄荷、鼠粘子、童便、山豆根之类以清之，或兼用冰硼散以吹
之，然后，余症俱从缓治。
痧之为害，治之虽愈，若一有未除，即复肆毒，又遍周身。如在表者已刮；在中者已放；而在内者少有未消，一吃
米饭或热汤、热酒，痧毒即复，由内而攻表，遂遍周身。如在内者已治，在中者已放，而在表者未刮，即复由外而攻内。
若表里具尽治矣，而在中者未放，亦复传遍表里。如此可畏之极，真生死所关，非杂病所得而比也，故治痧当绝其根。
痧症先吐泻而心腹绞痛者，从秽气痧发者多；先心腹绞痛而吐泻者，从暑气痧发者多；心胸昏闷，痰涎胶结，从伤
暑伏热痧发者多；遍身肿胀，疼痛难忍，四肢不举，舌强不言，从寒气、冰伏过时，郁为火毒而发痧者多。
腰背巅顶连风府胀痛难忍，足太阳膀胱经之痧也。两目红赤如桃，唇干鼻燥，腹中绞痛，足阳明胃经之痧也。胁肋
肿胀，痛连两耳，足少阳胆经之痧也。腹胀板痛，不能屈伸，四肢无力、泻泄不已，足太阴脾经之痧也。心胸吊痛，身
重难移，作肿、作胀，足厥阴肝经之痧也。痛连腰肾，小腹胀硬，足少阴肾经之痧也。咳嗽、声哑、气逆发呛，手太阴
肺经之痧也。半身疼痛，麻木不仁，左足不能屈伸者，手太阳小肠经之痧也。半身胀痛，俯仰俱废，右足不能屈伸者，
手阳明大肠经之痧也。病重沉沉，昏迷不醒，或狂言乱语，不省人事，手少阴心经之痧也。或醒、或寐、或独语一二句，
手厥阴心包络之痧也。胸腹热胀，揭去衣被，干燥无极，手少阳三焦之痧也。
痧症，属于急症。如果出现昏迷不醒、口不能言，心中烦闷，有一种难以忍受的痛苦，该如何辨别呢？治疗应当先观察其唇舌的颜色。颜色发黑的预后凶险；颜色发黄的症状较重；颜色淡红的，相对较轻。因为黄色可知内有热邪，黑色可知热邪极盛，淡红色虽然也有热，但用药不可过于寒凉。还要看舌苔有或无，这样病症的治疗法则才明确。
痧症危急时，若大便不通，应立即放痧并采用攻下法治疗；小便不通，应放痧并采用分利小便的方法治疗。
痧症危急时，若病邪侵犯咽喉，则痰多气喘声如拉锯，应先放痧，急用薄荷、牛蒡子、童便、山豆根等药物来清热，或者兼用冰硼散吹入患处，然后其余症状再按缓治处理。
痧症的为害，虽然治疗好了，但如果有一处未除尽，毒邪就会再次肆虐，遍布全身。如果在表的痧已刮治，在里的痧已放血，而在内的痧稍有未消，一旦吃米饭或喝热汤、热酒，痧毒就会复发，由内向外攻窜，遂遍及周身。如果在内的痧已治，在中的痧已放，而在表的痧未刮，就会再次由外向内攻陷。如果表里都已彻底治愈，而在中的痧未放，也会传遍表里。如此可怕至极，真是关乎生死的大事，不是普通杂病所能比拟的，所以治疗痧症应当斩草除根。
痧症先出现呕吐腹泻而后心腹绞痛的，多是从秽气引发的痧症；先心腹绞痛而后呕吐腹泻的，多是从暑气引发的痧症；心胸昏闷，痰涎胶结，多是从伤暑伏热引发的痧症；遍身肿胀，疼痛难忍，四肢不能活动，舌强不语，多是从寒气、冰伏过时，郁积化为火毒而引发的痧症。
腰背、头顶连及风府穴胀痛难忍，是足太阳膀胱经的痧症。两目红赤如桃，唇干鼻燥，腹中绞痛，是足阳明胃经的痧症。胁肋肿胀，疼痛连及两耳，是足少阳胆经的痧症。腹胀板硬疼痛，不能屈伸，四肢无力、泄泻不止，是足太阴脾经的痧症。心胸吊痛，身体沉重难以移动，作肿、作胀，是足厥阴肝经的痧症。疼痛连及腰肾，小腹胀硬，是足少阴肾经的痧症。咳嗽、声音嘶哑、气逆呛咳，是手太阴肺经的痧症。半身疼痛，麻木不仁，左足不能屈伸，是手太阳小肠经的痧症。半身胀痛，俯仰动作均废，右足不能屈伸，是手阳明大肠经的痧症。病情沉重，昏迷不醒，或胡言乱语，不省人事，是手少阴心经的痧症。或清醒、或睡眠、或独语一二句，是手厥阴心包络的痧症。胸腹热胀，揭去衣被，干燥至极，是手少阳三焦的痧症。
Sha disease (Sha Zheng, acute toxic heat syndrome) is an emergency condition. If the patient falls into a coma without regaining consciousness and cannot speak, experiencing mental restlessness and unbearable distress, how should it be differentiated? Treatment should first involve observing the lips and tongue. A black color indicates a poor prognosis; a yellow color indicates severe symptoms; a pale red color indicates relatively milder symptoms. Yellow indicates internal heat; black indicates extreme heat; although pale red also involves heat, medicinal treatment should not be overly cold. One must also observe whether there is a coating on the tongue, at which point the treatment principles for the syndrome become clear.
In critical Sha disease, if defecation is obstructed, immediate bloodletting (Fangsha) combined with purgative therapy is indicated; if urination is obstructed, bloodletting combined with diuretic therapy to separate fluids is indicated.
In critical Sha disease, if the pathogen invades the throat, resulting in profuse phlegm and wheezing sounding like a saw, one should first perform bloodletting, urgently using herbs such as Bohe (Menthae Haplocalycis Herba), Niubangzi (Arctii Fructus), Tongbian (Urine of a Healthy Child), and Shandougen (Sophorae Tonkinensis Radix) to clear heat, or alternatively apply Bingpeng San (Ice and Borax Powder) by insufflation into the affected area. Subsequently, remaining symptoms should be treated according to gradual methods.
The harm caused by Sha disease is such that even if cured, if any part remains uneliminated, the toxin will flare up again and spread throughout the body. If the Sha in the exterior has been scraped (Guasha), and the Sha in the interior has been bled, but the Sha within the organs is slightly unresolved, consuming rice, hot soup, or hot wine will cause the Sha toxin to recur, attacking from the interior to the exterior, thus spreading all over the body. If the Sha in the interior has been treated, and the Sha in the middle has been bled, but the Sha in the exterior has not been scraped, it will attack from the exterior to the interior. If both exterior and interior have been thoroughly treated, but the Sha in the middle has not been bled, it will still transmit throughout the exterior and interior. This is extremely terrifying, truly a matter of life and death, incomparable to ordinary miscellaneous diseases. Therefore, treating Sha disease requires eliminating its root.
Sha disease presenting initially with vomiting and diarrhea followed by colicky pain in the heart and abdomen is mostly caused by Sha due to foul qi (Huiqi). Sha disease presenting initially with colicky pain in the heart and abdomen followed by vomiting and diarrhea is mostly caused by Sha due to summerheat (Shuqi). Mental confusion and oppression, with sticky phlegm and saliva, is mostly caused by Sha due to summerheat injury and latent heat (Shangshu Fu Re). Generalized swelling, unbearable pain, inability to move the four limbs, stiff tongue, and inability to speak is mostly caused by Sha due to cold qi and ice-stagnation transforming into fire toxin after passing the appropriate time.
Distending pain in the lower back, back, vertex, and Fengfu (GV16) that is unbearable indicates Sha of the Foot-Taiyang Bladder Meridian (Zu Taiyang Pangguang Jing). Red eyes like peaches, dry lips, dry nose, and colicky abdominal pain indicate Sha of the Foot-Yangming Stomach Meridian (Zu Yangming Weijing). Swelling of the hypochondrium and ribs, with pain radiating to both ears, indicates Sha of the Foot-Shaoyang Gallbladder Meridian (Zu Shaoyang Danjing). Abdominal distension with board-like pain, inability to flex or extend, weakness of the four limbs, and continuous diarrhea indicate Sha of the Foot-Taiyin Spleen Meridian (Zu Taiyin Pijing). Hanging pain in the chest and heart, heavy body difficult to move, swelling and distension, indicate Sha of the Foot-Jueyin Liver Meridian (Zu Jueyin Ganjian). Pain radiating to the waist and kidneys, with hardness and distension in the lower abdomen, indicates Sha of the Foot-Shaoyin Kidney Meridian (Zu Shaoyin Shenjing). Cough, hoarseness, rebellious Qi, and choking sensations indicate Sha of the Hand-Taiyin Lung Meridian (Shou Taiyin Feijing). Unilateral body pain, numbness, and inability to flex or extend the left leg indicate Sha of the Hand-Taiyang Small Intestine Meridian (Shou Taiyang Xiaochangjing). Unilateral body distending pain, inability to bend or stretch, and inability to flex or extend the right leg indicate Sha of the Hand-Yangming Large Intestine Meridian (Shou Yangming Dachangjing). Heavy illness, coma, unconsciousness, or delirious speech and loss of consciousness indicate Sha of the Hand-Shaoyin Heart Meridian (Shou Shaoyin Xinjing). Alternating between wakefulness and sleep, or speaking alone for a sentence or two, indicates Sha of the Hand-Jueyin Pericardium (Shou Jueyin Xinbaoluo). Heat and distension in the chest and abdomen, removing clothes and blankets, and extreme dryness indicate Sha of the Hand-Shaoyang Sanjiao (Triple Burner) Meridian (Shou Shaoyang Sanjaojing).